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Should the UK legalise drugs?

Cannabis is the poster-boy for the liberalisation of drugs campaign that is sweeping the US (in state-legislation) and has had a significant following since the 1990s in the UK. By users cannabis has always had the nanny-state reputation of being illegal for reasons separate from harm. Whilst there is some grounding in support of keeping it scheduled as a Class B controlled substance, there are also other powerful arguments in support of a law reform.

It is proven that cannabis has a negative impact on cardiopulmonary conditions but other areas of research into the drug are murkier. Possibly the most significant anti-cannabis perspective is that of mental well-being. There are studies that suggest long-term use of cannabis increases the likelihood of developing psychosis. Often it’s one of the first health associations or assumptions people make. But, there is no research that that can say definitively one way or the other. The psychoactive compound found in cannabis, THC, could worsen existing mental health problems such as schizophrenia. We all remember those Talk To Frank ads, right?

In a greater amounts of users, but with less severe effects, cannabis contributes to a wide range of health problems from respiratory issues, anxiety, paranoia and depression. As yet there is no proven causal link between the use of cannabis and cancer. It is more likely that we haven’t found the link (rather than there not being one) due to current legislation making research-access to illegal drugs immensely difficult.

Ex-government drug advisor Professor David Nutt, who famously got fired in 2009, told the Guardian, “regulations, which are arbitrary, actually make it virtually impossible to research these drugs”. Nutt compared the governmental veto on cannabis and MDMA (ecstasy) studies to George Bush’s conquest to prevent stem cell research, saying that it was “a tougher case because it’s been going on since the 60’s”.

Often you hear scientists pining after miracle compounds that can ‘cure’ cancer, usually in response to fervent deforestation. But there are a whole, largely unresearched, group of drugs that have significant medical potential that scientists are effectively disallowed to experiment with. Legislation needs to be untangled so the complicated chemical mechanisms of illegal drugs can be explored to discover what their useful therapeutic qualities are.

Studies exist that indicate, in fact, some of them have real value. For example, UCL are currently exploring the relationship between THC and Cannbidiol, so far they’ve found that Cannabidiol could dampen the negative mental effects of THC and also that it has anti-addictive properties.

Cannabis is a Schedule 1 drug, which means that the government considers it as having no therapeutic benefit. We couldn’t find out who schedules illegal drugs, although it’s clear the Home Office makes the final call. There are currently only four hospitals pharmacies in the UK that hold a licence to possess cannabis legally. The licence itself costs around £5,000 to enact, and takes a year to process. Staggeringly, cannabis placebos (without any of the compounds that gets you high) is also a schedule 1 drug so research is effectively gone, as they say, up in smoke.

Peter Reynolds, party leader for prominent pro-legalisation campaign CLEAR Cannabis Law Reform who we interviewed last month, said that “the primary aim of any decisions about the legality of drugs should be focused on the reduction of harm”. Harm not only relates to the physical and psychological effects on the user but also, and arguably more importantly, social harm from drug-related crime to home life issues and education. In 2009 Professor Nutt was dismissed from his position as chairman for the Advisory Council on the Misuse of Drugs (ACMD) due to a lecture where he “crossed the line from science to politics“. He published a paper which drew controversial conclusions, below is a graph from that report on the relative harms of drugs.

Professor Nutt used a complicated statistical algorithm to configure a ‘harm index’. What the graph shows is that alcohol causes more harm than heroin, and that tobacco causes more harm than cannabis. Of course both alcohol and tobacco are more widely available than cannabis and heroin, but that doesn’t contradict the point that alcohol and tobacco are seriously harmful, far more harmful than some illegal drugs. We seem to be stuck in a drug-law rut, where we’re continuing the same thing, over and over again, and expecting different results – that’s how Einstein defines insanity.

In the US, 21 states allow the use of medical cannabis for the alleviation of pain and other illnesses. Whilst four states have fully legalised the drug. The validity of cannabis use as a medicine is contested by some. In the UK a certified drug called Sativex is available through prescription. The way the drug is produced, essentially, is an alcohol solution called a tincture in which compounds from specially grown cannabis plants are dissolved. Peter Reynolds, CLEAR party leader, told us in interview that “Sativex is cannabis, there is no other way to describe it”.

NHS England currently does not offer it to their patients due to its prohibitively expensive price tag. However, NHS Wales does offer Sativex to sufferers of Multiple Sclerosis for relief of spasticity. GW Pharma is the company that produces Sativex, the drug is an oral spray which delivers a calculated dose of THC and Cannabidiol.

The licensing of Sativex for prescription in the UK condones, at a decision-making level, that the active compounds in cannabis are effectual on some illnesses. As Professor Nutt describes them “arbitrary rules” on drug legalisation seem to stem from social stigma and politicking rather than scientific, empirical research.

The Misuse of Drugs Act 1971 is the piece of legislation that controls drugs in the UK. The act itself was a progressive piece of legislation. Peter Reynolds told us that “when the bill was passed its intention was to create a system of regulation based on advice from a select committee of scientists, it was an attempt at removing politics from the equation”. What actually happens is that the politicians choose which advice to follow, likely to be based on votes rather than a concerted effort at reducing harm.

Professor Nutt’s 2009 dismissal stands testament to this. Current Prime Minister David Cameron used to hold different views about drug policy, he once suggested, before his leadership of the Conservative party, that the state should legalise drugs and establish heroin prescriptions and create “shooting galleries”. Now, the Home Office “has no intention of legalising cannabis”, David Cameron added “I don’t believe in decriminalising drugs that are illegal today”. Clearly Cameron doesn’t believe in integrity either.

The national newspapers choose sides on the cannabis conversation. Recently the Telegraph and the Daily Mail published sensational headlines concerning a ‘twenty-year study’ that finds “cannabis is more addictive than heroin”. The study in question was written by Professor Wayne Hall who is the director for Youth Substance Abuse Research at the University of Queensland. We spoke to Professor Hall, he said “that’s not what the study says at all, in fact, if you read it, it says quite the opposite”. CLEAR Cannabis Law Reform party have logged complaints with the Independent Press Standards Organisation (IPSO) on grounds of misrepresentation. Professor Hall added, “the paper was what is called a longitudinal study, which is looking back at different pieces of research from the past and finding new links”.

The cyclic system of stigmatising drug users, penalising them, and not offering enough support upon release creates a network of underserved, unemployable and forgotten citizens.

Any law reform needs to not be focused on leftfield liberalisation, but on real issues that are negatively affecting our society in a varied and complex way. Often the convincing arguments for the legalisation of drugs are marred by the unenlightened, anarchic sort who just want to buy cannabis on their high-street – but really that’s not what it should be about at all.

Logistically it would be simpler than you might initially think to establish a UK market. Medical cannabis could be imported from Nederland-based company Bedrocan, who have the resilience in infrastructure to support such a move. Relocating cannabis from Schedule 1’s ‘no therapeutic qualities’ to Schedule 4 (alongside steroids and benzodiazepines) would be confirmation of its medical value, whilst decriminalising possession would remove common drug use from the police’s responsibility. But will it happen?

Statistics coming out of Colorado (one of the states where recreational cannabis is legalised and very much established) suggests nothing but good news. Whilst only six months of data exists, violent crime has fallen by 4.8% and major property crime (burglary) fell by 11.4%. When compared to the month by month staggering increase in revenue, 35% between February and March to $19 million, it seems as if it really is a “smarter approach“.

Vice’s investigative outlet Motherboard produced this illuminating documentary about what’s happening under the skin in Colorado right now.

The CLEAR campaign commissioned an independent IDMU study into a taxable UK cannabis market, and estimated an annual £6.8 billion in revenue straight into the economy and out of the pockets of street dealers and criminals. An intelligent approach would be to appropriate this money directly into research, education and support infrastructure to build towards a future of safer controlled drug-use.

Because, let’s be honest, they’re loads of fun and we’re going to do them anyway.

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9 comments

Please allow me to correct a couple of errors in this otherwise excellent summary. You wrote

“The psychoactive compounds found in cannbis, THC and cannabidiol, can worsen existing mental health problems such as schizophrenia”. Cannabidiol (CBD) is actually an antipsychotic, it not only doesn’t create psychosis it actually protects against it.

The claim often made by prohibition campaigners is that “modern” strains of cannabis (so-called “skunk”) has elevated levels of THC and reduced levels of CBD compared with the “traditional imported hashish” we used to enjoy from North Africa. It is this lack of CBD that is claimed to have made so-called “skunk” more dangerous.

As to whether cannabis is a cause of psychosis the truth is far less certain than you state. The people at risk seem to be the people who are at risk anyway. Actual rates of serious mental illness have not risen over the past 50 years, despite the huge uptake of cannabis use in that time. That would seem to imply cannabis is not a cause of psychosis.

An excellently written and well thought out piece . Should we not appeal to all those voter facing higher tax bill who could be paying less tax if a taxed and regulated cannabis supply system was in place. Many of whom are the Tory hardliners being of the upper classes who own larger properties and are getting hit by the mansion tax and increases in stamp duty?

The other thing I hate is the lies printed in the press about cannabis and the view we must fight against these lies with the truth. Why not print unsubstantiated lies ourselves and let them prove us wrong? After all that’s how G W Pharma got their licence.

Also each time we hear that the police don’t have the resources to investigate crimes (Child Exploitation and Online Protection Centre and the 2.000 pedophiles passed to them by the Canadians) we should make the point of how much time and resources would be freed up if we legalize drugs.

Taking any substance is a victimless crime so lets first protect others from those who wish to cause harm or loss.

It is proven that cannabis has a negative impact on cardiopulmonary conditions ? it is proven by who?? did you mean smoking cannabis has negative impact on cardiopulmonary conditions? and that is caused by the smoking..not the cannabis itself, what about cannabis in edible on vaporized preparations, how do you think can affect to any cardiopulmonary condition at all. if fact, the antioxidants and anti inflammatory effects of the hundreds different compounds in cannabis are been used and researched as potential treatment for asthma, cardiovascular diseases etc.

Thanks for commenting on my story, If you click through to the link where it mention cardiopulmonary conditions you’ll be able to see some research that supports that claim. I’m not a scientist, and I don’t propose to be one, but I would think that regardless of the intake method cannabis is proven to increase heart rate, and to a lesser extent increase blood pressure, due to the active compounds in the plant.If you are in doubt please read the following;

I read the documents you provided,
the first one stated very clearly that is a self reported use of cannabis, well, even in the study they recognized something that is very obvious, not all people would tell if they use or have used cannabis, mostly because the stigma associated but also to the illegal status of the plant. so you can not get accurate conclusion from self reported studies like this one, furthermore, the study is entirely about smoked cannabis, more frequently mixed with tobacco. Everybody knows smoke and tobacco are on his own merits risk factors for myocardial infarction….so you can not link cannabis ..only smoke from cannabis, or cannabis-tobacco mix. what about ingested cannabis, or even inhaled cannabis?? what about all the people interviewed in the study that decided omit their cannabis use for many reasons.
2. the abstract in the second one states. “, there are few data regarding marijuana/THC use and cardiovascular disease outcomes. A large cohort study showed no association of marijuana use with cardiovascular disease hospitalization or mortality” bur furthermore it also states “The acute physiological effects of marijuana include a substantial dose-dependent increase in heart rate, generally associated with a mild increase in blood pressure. Orthostatic hypotension may occur acutely as a result of decreased vascular resistance. ” if is dose dependent, that that mean a low dose, or a not heavy use associate to a lower increase of hear rate, more like a low or hight exercise associate to a low or high increase in hight rate? also to pint out…mild increase in blood pressure and hypotension as result of decrease vascular resistance, sound contradictory in a first view, cannabis increases or decreases blood pressure? and also states ” Patients who have coronary heart disease or are at high risk for the development of CHD should be cautioned about the potential hazards of marijuana use as a precipitant for clinical events” but more study is needed. of course, nothing of the above is clearly associated to cannabis as a cause of heart disease, only a potential.. just as watching porn could be a potential for heart problems but there is not enough research about that. ( by the way, in seems that all the research mentioned in the abstract is related to smoked cannabis, so same applies regarding smoke inhalation, or using cannabis in other forms with not smoke involved.)
3- this one is even funny, it started stating “For over three decades it has been known that cannabis has pathophysiological effects on the cardiovascular system” it is known by who?? it something is clear about cannabis is that because the illegal status in UK and USA and many other countries, there is little known about cannabis, research is very restricted and specially in USA, mostly research has been granted exclusively to try to find the ” harms” of cannabis, but not the benefits. you only have to look in the news to find how fast the USA administration and the institution dependent of the federal government fired or cancel any study that hints to any benefits of cannabis, but advertise any research that highlight any potential harms. fortunately we will know more in the next few years as people are more aware of the political manipulation of the truth about cannabis.
anyway.. still the same. smoke is bad, everybody knows that, but still far to prove that cannabis, in not smoked form, is harm. also would be interesting to know how the relaxing and anti stress properties of cannabis affects to the cardiovascular system in disease prevention, considering all the research about the antioxidant and anti inflammatory effect of cannabinoids (even the USA federal government registered a patent on this years ago) in the body coming to light lately and in the future,

Thanks for you in-depth and lengthy response. As I mentioned before I’m not a scientist so I don’t have any meaningful understanding of medical conditions, whether or not a certain drug causes them or not. I agree with your point that US and UK legislation essentilly prohibits the use of cannabis in research, and yes, often the only research trials that gain license or funding tend to be with regards to associated harms. Although, that said, it doesn’t negate the validity of the research in the first place – it is an academic requirement for research to be conducted in a very specific manner – ‘self-reported’ studies as you call them is a valid way of going about such research, and in the methodology I’m sure the author has analyse both the merits and shortfalls of such a study. Another point to consider is that these studies add to a bigger picture, and in themselves cannot, and don’t attempt to, be conclusive.

I can, however, refer you to Professor Wayne Hall’s research. He is currently chair of the Center for Youth Substance Abuse Research at Queensland University and is considered to be a world-leading expert in addiction. He recently published a longitudinal study that drew influence from drug research spanning twenty years. He found that;

– Daily use of cannabis doubles the risk of developing psychosis
– Smoking the cannabis increases risk of cardiovascular disease (as you correctly pointed out correlated with tobacco)
– Daily use of cannabis starting from adolescence is linked to cognitive impairment (although the mechanism is not understood)

I think, Fernando, we’re saying the same thing, just in a slightly different way. I don’t think cannabis is the scary thing the media and government would have you believe, but you’ve read my story so you must know I’m pro-legalisation, but at the same time it’s important to keep a balanced head about things and it is very likely that cannabis causes harm, its just to what degree we need to figure out.

Studies based in self-reported patients are valid, but are very vulnerable to bias, as explained in the limitations section of the study, cannabis use is a criminal offense, there is stigma related to using cannabis, and it can affect to the self reported data obtained, and to the over or underestimation of the risk, . of course you can try to control the confounding factors, but still it does not mean that people are going to report their real use of a illegal substance with stigma and criminal consequences attached to its use and possession, even if you assure them that is confidential information, but as the study point they may hide their regular use but disclose the recent use of cannabis closer to the onset of symptoms because it could provide them clinical benefits if they are sincere, dealing to overestimating of the risk. I known several people that use cannabis regularly or occasionally that would never disclose their use in a country like UK and only would do it if they think is relevant to that particular occasion. your experience could be different, but scientifics and clinicians doing this research does not have superhuman powers to read people’s minds, they are limited and they are only able to work with the data available, and to estimate or hypothesise and any conclusion based in this only suggest that more research is needed because the evidence is weak. even so, in the conclusion they recognize that smoking cannabis is a rare trigger of myocardial infarction and may pose a health risk to patients with established coronary artery disease and perhaps, to individuals with multiple coronary risk factors. but as the ” may ” and ” perhaps” indicates, could be said of sex, watching a rugby or football match,or drinking a few cup of tea or coffee, or even walking upstairs as all could elevate the heart rate of a person and trigger a myocardial infarction ( the hypothesis is the effect of cannabis in a MI is that it could cause increased heart rate and a atheroma fragment could be disturbed by this increment of heart rate cause displacement and obstruction of an coronary artery, hence any significant increment of heart rate, caused by any other cause could be also blamed as causing the same effect, not only cannabis)
that is why it is very important clarify that correlation is not the same as causation. I could get hit by a car crossing a street and the postmortem examination shows that i have nicotine or caffeine in my system at the time of the death, but would anybody consider the nicotine or the caffeine the cause of my death? that is what they are trying to do with cannabis, and because is a widely available and frequently used substance across all society, the likelihood to associate cannabis to many events is too tempting, but association is not causation neither.
and that lead me to you mentioning professor Hall’s study, Professor Hall has a long running association with the National Cannabis Prevention and Information Centre, whose self-stated mission is to fight marijuana use across Australia, can someone so potentially biased to produce a bias free report? It could but I doubt it you give a good look to the report itself. but summarising, it is worth to read the analysis of the report published in the NHS. uk website where clearly states that the study is a narrative review and it is not clear how the author identified the studies used as a basis for the review and he could have not include many other studies that show no harm in the review. it is difficult to conclude from this review that cannabis causes the effects seen on this observational studies and a systematic review is needed.

I think that professor Wayne Hall has much to explain if there is any personal agenda on his ” interest” against cannabis use and his report.

As you said, cannabis it not harmless, and even water can cause harm when abused , but the importance here is if is more or less harmful than many other things available legally to people, and if most of the the harms associated to cannabis, are in fact caused by cannabis. In a prejudiced society like our, is hard to known ( and sincerely, even the most prestigious scientific mind had beliefs and prejudices, but some people are more professional than others and try harder to avoid their prejudices and their interests getting in the way or scientific research in benefit of knowledge and humankind. And this is applicable to everyone, from the nurses to politicians in the parliament.

I work in a emergency department of very busy hospital, and sincerely, considering the amount of presentations, health problems, accidents and admissions related to alcohol and tobacco, compared to cannabis, I am shocked the government has not made illegal the former and legalized cannabis many years ago. Instead, the fired Professor David Nutt as chairman of Advisory Council on the Misuse of Drugs for suggesting a reclassification of drugs based in the scientific evidence available, that was the purpose of the ACMD anyway. If that is not prejudice and hypocrisy I don’t what it is.

“Smoking pot can increase your heart rate by as much as two times for up to 3 hours. That’s why some people have a heart attack right after they use marijuana. It can increase bleeding, lower blood pressure, and affect your blood sugar, too.”

One of the effects of using cannabis is a process called Vasodilation, the walls of blood vessels relax allowing them to open up and hence carry more blood. So the heart beats faster not because it’s raising the blood pressure, but because resistance to it pumping is reduced – much as happens with a central heating system when the valves are opened. In most people this counts as a benefit because the heart is actually put under less stress as the result of using cannabis.

In short this is (yet) another of those “risks” of using cannabis that isn’t quite what it seems, the truth is far more nuanced.